Dear Honest Midwife,

Thank you so much for willing to be honest and give up your entire livelihood and community to do so. I have struggled with the truth about home birth for years, and I realized it was like a religion to me. I knew all the "correct" answers to give to explain away problems with homebirthing. Within my small circle of friends, I learned of many scary situations and complications that happened during home births. I was careful to "support" the homebirthing community by not trumpeting these experiences loudly, but over time I realized that it just wasn't nearly as safe as we'd all believed. 

I was sad to lose my "faith" in homebirth, but I didn't really have to face it, because I wasn't having any babies. Well, I am now pregnant again! What do I do now? I've had 2 homebirths. How do I go back to the hospital?

I know that during a hospital birth the CNM or doctor is not there with you in the room much. How can that be better than homebirth, where the midwife is there the whole time? Granted, I've looked back at my homebirth records, and I was only monitored with a doppler ultrasound 4-5 times during my very long pushing phase. 

I'm guessing I'd prefer not to have all the typical interventions that might make a hospital safer, like a continuous IV, continuous monitoring, and so on. If I don't do those, what's better about hospital birth? How can homebirthers emotionally/spiritually go back to hospital birth?

Thank you!

Dear Krista,

a laboring woman is monitoredGoing to the hospital to have a baby after being a homebirth mom can be emotionally tough! I understand your anxieties. It very likely is the interventions that you don’t prefer that often make hospital birth safer. Continuous monitoring, IVs, and access to surgery and expert resuscitation are among the things that give hospitals such high survival rates, far and above the “natural” survival rates for mothers and babies. I know that many of these interventions seem uncomfortable. 

As a mother you know that your baby would prefer to be held by you as you travel down the highway in a car. But we keep our babies strapped into carseats to keep them safe, even when it’s not the most comfortable. We know that safety in the car trumps comfort. The same applies in birth. Monitors aren’t especially comfy, but they make our babies much safer. As a mother, we would do anything, no matter how painful, to keep our born children safe. Would you run barefoot over broken glass to save your toddler from being run over by a train? Of course you would. Without a moment’s hesitation. I think our unborn children deserve that level of sacrifice too. Surely we can deal with some straps around our belly for them. 

That said, I have attended many natural births (and some really nice epidural births) in hospitals as a doula, and they have been really wonderful. They don’t keep the monitors on all the time, they let you change position to stay comfortable, and they do whatever they can to help you get what you want as long as it is safe. Maybe you could interview some local hospital-friendly doulas and share some of your concerns. You might find out that the hospital is not the boogeyman that your old "religion" taught you it was!  

You hit the nail on the head with your thoughts about the lack of monitoring at home birth. Just having someone in the room with you isn’t adequate monitoring for the baby. 4-5 times listening during a long pushing phase sounds incredibly dangerous. In a hospital, they don’t need to be in your room at all times in order to be giving safer care. They can even do intermittent monitoring (for example, a continuous strip for 20 minutes out of each hour, and off the monitor for 40 minutes) and ensure safety while not sitting in your room the whole time.

My overall impression reading your comment was that you are still nursing some fear regarding hospitals. That fear was placed there intentionally by people who were proselytizing to you, who were themselves deceived. You know that facts are facts, and that having a living and undamaged baby is vastly more important than all the beautiful lies that we homebirth moms all told each other. You have woken up in time to do what’s best for this baby. It won’t be easy for you, and will require some surrender. This time, surrender to what you know is best and safest, instead of the fear. 

Best wishes to you for a safe and healthy pregnancy and birth!


Honest Midwife

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